Surgical treatment of endometriosis focuses on the elimination of peritoneal endometriosis / endometrioma /deep endometriosis and division of adhesions. In the past, open surgery (laparotomy) was used routinely, nowadays, keyhole endometriosis laparoscopic surgery is used frequently and preferred since it usually results in less pain, shorter hospital stay, quicker recovery and a smaller scar. Clinicians should consider surgical treatment (elimination of endometriotic lesions) when they see endometriotic lesions during laparoscopy endometriosis for diagnosis.

If deep endometriosis is suspected and these surgeries may be difficult, doctors are recommended to refer you to a centre of expertise. You may be offered hormone treatment after surgery, as it could improve the immediate outcome of surgery for pain and could prevent recurrence of disease/symptoms. When you desire pregnancy shortly after surgery, hormone treatment should be avoided. While surgery is generally effective for relieving pain symptoms, it may not always improve all symptoms and relieve symptoms only partially or temporarily. There are currently no means for clinicians to identify women with endometriosis that will have a significant benefit of surgery for certain.

If you have completed your family and other treatments have not worked, you may consider, removal of the uterus (hysterectomy) with or without removal of the ovaries. This is a radical and irreversible option which results in so called surgical menopause and menopausal symptoms (hot flushes, etc) if the ovaries are removed at the same time. You should know that hysterectomy does not always solve the problem, since sometimes endometriosis inadvertedly is left behind and hence the pain symptoms remain present.

Hysterectomy may help if your symptoms are mostly due to adenomyosis and should be considered if other treatments have failed. Hysterectomy can be performed if you failed to respond to more conservative treatments and if you no longer wish to conceive. Still, you should be aware that hysterectomy will not necessarily cure the symptoms or the disease.

Endometriosis is a chronic disease. In that sense, there is no cure for endometriosis, but the symptoms can be reduced with the right treatment. Women with endometriosis have either pain, fertility problems or they have both.

The treatment of choice for pain related to endometriosis outside the pelvis (extrapelvic endometriosis) largely depends on the location of the endometriosis. For abdominal extrapelvic endometriosis: Surgical removal is the preferred treatment, when possible, to relieve symptoms.

If surgery is indicated, it should be performed involving a thoracic surgeon and/or other relevant specialists.

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